Insurers see membership gains despite profitability concerns

Increased enrollment in 2015 did not translate to higher profit margins among the nation's largest insurers, according to an analysis by Mark Farrah Associates, which aggregates health plan data.

The country's top seven insurers added 3.4 million new members to their ranks, thanks to higher enrollment in commercial risk-based plans, public exchanges, Medicaid and self-funded plans. UnitedHealth maintained its position as the nation's largest insurer, adding 1.46 million beneficiaries in 2015, an 8.1 percent increase from 2014. That number is likely to drop in the coming year since UnitedHealth announced it will pull out of Affordable Care Act exchanges in the majority of states in which it operates. Anthem, the second-largest insurer, reported an increase of 1.1 million new members.

But more members did not lead to higher profit margins. Aetna was the only insurer to report a small profit margin increase, from 4 percent in 2014 to 4.2 percent in 2015. UnitedHealth, Kaiser Permanente and Anthem all reported a drop in profit margins ranging from 0.3 to 2.3 percentage points.

Earnings reports for the end of 2015 indicated ACA exchange products continue to raise concerns about profitability, particularly as insurers take on sicker, more expensive members. Financial figures for the first quarter of 2016 offered a mix bag for the largest five insurers.